ArticleDermatology and therapy2026
A Conceptual Disease Model of Symptoms and Impacts in Adults with Prurigo Nodularis: A Qualitative and Literature-Informed Study.
Article in Dermatology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPrurigo nodularis (PN) is a rare neuroimmune inflammatory skin condition characterized by intense, chronic pruritus that can greatly reduce quality of life. Treatment decisions are based on clinical judgment, considering individual patients' characteristics, disease severity, and potential side effects. The treatment aim is to reduce itch, heal the skin, and improve quality of life. Understanding patient perspectives about their symptoms and their impact can help guide treatment strategies. We developed a conceptual disease model (CDM) to help elucidate the concepts most important to patients and visualize how the signs and symptoms of a disease relate to functional status, quality of life, health perception, and outlook.
methodsThis CDM was developed based on previous qualitative research that was informed by a targeted literature review. The framework for this CDM development was informed by previous CDMs for chronic itch and atopic dermatitis and by the Wilson and Cleary conceptual model of patient outcomes. The CDM was finalized with input from clinicians specializing PN treatment.
resultsAmong the most burdensome PN symptoms, itch, pain, stinging, burning, and bleeding have a tremendous impact on patients' quality of life, including affecting emotional wellbeing, sleep, and daily functioning. In our CDM, the primary clinical manifestations of PN were itchy lumps or bumps and lesions or sores, but the various symptoms and impacts of PN are all interlinked. Most impacts of PN, such as those on sleep and emotions, are directly linked to itching, although for some impacts the link is indirect.
conclusionThe CDM presented here outlines the significant effects of the itch-PN scratch cycle on patients' lives. Identifying these effects as crucial targets for a comprehensive treatment management plan can help clarify how PN-associated pruritus disrupts patients' quality of life.
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